AGETECH AND THE ETHICAL IMPERATIVE

Abstract “AgeTech” refers to technological trends in e-health, robotics, artificial intelligence (AI), and mobile technologies” as a way to improve the health, well-being, independence, and social participation of older people. This symposium provides an overview of the imperative to integrate ethics into the design and development of technology, from start to finish. The first talk presents reflections from older adult members of two AgeTech groups: AGE-WELL’s Older Adults and Caregivers Advisory Committee, and the Research Group of Seniors 411, which will outline the ethical issues and ageism experienced by older adults. To further examine these issues, the second presentation explores a framework for how ageist attitudes can be encoded and perpetuated as digital ageism, both in AI and other technologies, and highlights a need for broader community inclusion. The third paper explores the challenges of virtual community inclusion, highlighting the challenges and benefits of digital participation in a post-COVID world. A health equity focus will be applied when highlighting the unique needs of seldom-heard and under-served older people in virtual spaces to enhance social inclusion. The last paper will highlight the “ethical by design” approach that will encourage and support culture change within AgeTech research and industry. This symposium will contribute to a more ethical, and inclusive design of technologies to support healthy aging.

Washington, United States,3. Washington State University Vancouver,Vancouver,Washington,United States With an aging population, knowledge about death, dying, loss, grief, and end-of-life (EOL) care is an essential skill for most physicians.However, EOL education has been minimally incorporated into medical school curricula in the United States (U.S.); there is a significant need to better prepare medical students for the unique challenges of improving patient wellbeing at end-of-life.To understand how death and dying topics have been incorporated into U.S. medical school education, we conducted a systematic scoping review, using PRISMA guidelines, of published research on death education for medical students between 2010 through 2022.An initial search in EMBASE and PubMed yielded 3,443 citations; 265 articles met the initial inclusion criteria (e.g., research-based, EOL education specific), with 97 articles selected for fulltext review.Overall, we found significant variation in the type and content of EOL training in U.S. medical schools.Using a competency-based medical education framework that reflects tangible knowledge, skills, and attitudes as a guide to ensure proper EOL training, a deductive coding approach yielded several themes including: reliance on brief, skills-based workshop interventions and limited longitudinal integration into curricula; general research on student attitudes and wellbeing; and an emphasis on needs assessments highlighting gaps in evidence-based EOL training interventions.Using these findings, we offer applied considerations for teaching EOL related skills in U.S. medical schools.In turn, this work contributes to the enhancement of health across the lifespan and might ultimately lead to a society where a "good death" is not an exception, but a reality.

AGETECH AND THE ETHICAL IMPERATIVE
Chair: Charlene Chu Co-Chair: Jennifer Boger Discussant: Andrew Sixsmith "AgeTech" refers to technological trends in e-health, robotics, artificial intelligence (AI), and mobile technologies" as a way to improve the health, well-being, independence, and social participation of older people.This symposium provides an overview of the imperative to integrate ethics into the design and development of technology, from start to finish.The first talk presents reflections from older adult members of two AgeTech groups: AGE-WELL's Older Adults and Caregivers Advisory Committee, and the Research Group of Seniors 411, which will outline the ethical issues and ageism experienced by older adults.To further examine these issues, the second presentation explores a framework for how ageist attitudes can be encoded and perpetuated as digital ageism, both in AI and other technologies, and highlights a need for broader community inclusion.The third paper explores the challenges of virtual community inclusion, highlighting the challenges and benefits of digital participation in a post-COVID world.A health equity focus will be applied when highlighting the unique needs of seldom-heard and underserved older people in virtual spaces to enhance social inclusion.The last paper will highlight the "ethical by design" approach that will encourage and support culture change within AgeTech research and industry.This symposium will contribute to a more ethical, and inclusive design of technologies to support healthy aging.

DIGITAL AGEISM AND ITS IMPLICATIONS FOR OLDER ADULT INCLUSION
Charlene Chu, University of Toronto, Toronto, Ontario, Canada "Digital ageism" is a new form of ageism that is embedded into technology and AI systems.Building on the World Health Organization's recently published policy brief entitled "Ageism in AI for Health", our work draws attention to digital ageism referring to the nexus of ageism (discrimination or bias related to age) that is mediated and perpetuated by artificial intelligent (AI) systems and technologies.This paper presents a conceptual framework for identifying various cycles of injustice that perpetuate ageism into our digital spheres.This framework also identifies key contributors that need to be addressed in order to break these cycles.We present the results of a scoping literature review, informed by Arksey and O'Malley, to identify the mechanisms in which digital ageism can be introduced as demonstrated in the literature.This work contributes to foundational knowledge about age-related biases in AI and how they might be encoded or amplified in AI systems.This work sheds light on the need for ethical thinking and other approaches to better include older people, and ensure technology benefits the aging population.

OLDER ADULTS' PERSPECTIVES ON ETHICAL ISSUES RELATED TO AGETECH
Olive Bryanton 1 , Gerry Dragomir 2 , Jim Mann 3 , and Marjorie Moulton 4 , 1. University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada, 2. AGE-WELL NCE,Toronto,Ontario,Canada,3. Community Engagement Advisory Network,Vancouver,British Columbia,Canada,Victoria,British Columbia,Canada Most funding programs in the AgeTech sector emphasise the involvement of the end user in research and innovation activities in order to strengthen relevance, appropriateness and real-world impact.However, this engaged approach is still a work in progress and often remains a matter of tokenism with older adults.Involving older adults is seen as key when creating ethically appropriate and inclusive AgeTech for their age group.This paper based on the reflections from members of two AgeTech groups: AGE-WELL's Older Adults and Caregivers Advisory Committee and the Research Group of Seniors 411 in Vancouver, BC.This paper highlights some ethical problems inherent in AgeTech, particularly how ageist assumptions can be built into technology-based healthcare, including the ongoing challenges of community participation, and presents a more radical agenda of older adults at the forefront of setting research priorities and shaping the development and implementation of AgeTech.Central to this is the building of community capacity; training to facilitate older adults' engagement in the research process: mobilizing expertise within the community to address local needs; developing mechanisms for connecting older adults and researchers in an integrated knowledge mobilization process.
The paper reflects on how this approach can have a significant impact on the lives of older people, and address the digital divide that marginalizes them.Remaining challenges include how to sustain older adults' participation in innovation initiatives, and providing hard evidence to demonstrate that a more engaged approach has tangible benefits and impact in terms of developing new products and services.

INCLUSIVE AGING AND DIGITAL PLACE-MAKING IN AGETECH: THE INCLUDEAGE PROJECT
Judith Sixsmith, and Mei Fang, University of Dundee, Dundee, Scotland, United Kingdom This presentation will address the challenges of virtual community inclusion for older people, with a focus on seldom-heard and under-served groups, such as those with intellectual and developmental disabilities (IDD) and those who identify as lesbian, gay, bi, trans + (LGBT+).Given that the COVID-19 pandemic has amplified the digital divide, further excluding marginalized social groups, the aim of this ESRC funded IncludeAge Project is to explore how virtual spaces can be made more inclusive to enhance social inclusion and support health equity.The presentation will consist of two key elements.Firstly, current discourses and definitions of 'community' and 'inclusion' in digital spheres will be discussed through findings from a scoping review.Secondly, the presentation will introduce new and innovative ways of digital participatory mapping working alongside older people with IDD and those who identify as part of the LGBT+ community using ArcGIS digital storymapping.This approach offers a unique and powerful way of including under-served groups in the design and development of inclusive AgeTech.The presentation will further highlight the challenges and benefits of digital participation in a post-COVID world, particularly for those who experience exclusion.It will demonstrate the importance of involving under-served groups in the design and development of digital spaces to enhance social inclusion and support health equity.To conclude, we will discuss how these new ideas might be used to shape government policy and organizational practices when it comes to the future of inclusive AgeTech research, design, and development with and for older people.

LEVERAGING AN "ETHICAL BY DESIGN" APPROACH TO CREATE MORE INHERENTLY RESPONSIBLE TECHNOLOGY TO SUPPORT AGING
Jennifer Boger, University of Waterloo, Waterloo, Ontario, Canada Responsible technologies are technologies that appropriately support the needs, abilities, and values of the people using them.While many aspects of responsible technology are ubiquitous, there are a multitude of considerations that are specific to older adults.These age-related aspects must be properly understood and incorporated into the technology development and selection process if technology is to be inclusive of and useful to older adults.However, as many of these aspects are subjective, qualitative, and/or dynamic, developers often consider them to be too abstract, undefined, or difficult to address, resulting in their omission from the technology creation process.In this presentation we will discuss